ON A cold, wet, dark night in January several years ago, people walking along the busy shopping area of a West Country city were bemused to see a young man kneeling on his own on the steps of a church. The church was closed and in darkness.
Several hours later, he was still there, and people working in the businesses near by became concerned and called for help from the authorities.
They were right to do so. The young man was suffering from an acute episode of schizophrenia, and his thinking was disturbed. Had he not got help at that time, then he might well have gone on to join the thousand or so people with schizophrenia who will die by their own hand each year.
Although the causes of this severe and disabling condition are still not understood, what is clear is that the previous experiences, thoughts, and ideas of those who have it will form the framework for the disturbed thoughts and ideas that they experience when they become ill. It is for this reason that the delusions and hallucinations that people with schizophrenia experience will often be religious in nature.
In fact, symptoms based on religion are so common in schizophrenia that psychiatrists have a name for it: religiosity. Research has indicated that in Europe and the United States probably about half the people with a diagnosis of schizophrenia will experience religious delusions at some point in their illness.
For instance, they may believe that they are God, a saint, or a prophet. Women sometimes believe that they are pregnant with the Messiah. In other cases, people with schizophrenia may believe that they are possessed by devils, or that they are being punished for some unpardonable sin in their past life. To many bystanders, it is, indeed, a mysterious condition.
BUT we have been studying schizophrenia now for more than 100 years, and we know a great deal more about it than we did. Schizophrenia is an illness of the mind rooted in physical and chemical changes in the brain. It causes disturbed thinking and equally disturbed behaviour; in particular, the person suffering from schizophrenia may experience hallucinations and delusions. These are the so-called positive symptoms; there are also commonly the negative symptoms, such as social withdrawal, lethargy, and lack of emotion.
Medication with some of the modern antipsychotic drugs is the mainstay of treatment in the NHS today, and is effective in at least relieving symptoms in most cases. Today, there is also an increasing appreciation of the beneficial part that talking therapies, such as counselling and psychotherapy, can play in recovery.
Schizophrenia is often a severe and disabling condition that prevents the person from working for many years, and the condition can often become life-threatening. Sadly, it affects mainly the young: three-quarters of all diagnoses are made between the ages of 16 and 25 — a period of life when religious and philosophical beliefs are often in a state of flux.
It affects men and women in equal measure, and cuts across all social classes and walks of life. It is a surprisingly common condition: more than a quarter of a million people are being treated for the illness by the NHS today.
ALTHOUGH we now understand schizophrenia much better than we did, and the prospects of recovery are better than ever, it is still none the less a challenging illness in social terms, and has an especially important challenge for people of faith. It is central to Christian belief that God gave us a free will, and yet for people with schizophrenia he has seen fit to deprive them of that quality, albeit temporarily. We may ask for what purpose?
We may also ask what happens to the soul of a person who is in the middle of a schizophrenic haze and detached from reality. Of course, we know that it must endure, but how is it nourished at these times?
People with schizophrenia who experience religious delusions and hallucinations will often find themselves drawn to a faith community as the natural expression for their disturbed thinking. In fact, it is often said that people with schizophrenia are more likely to present themselves to a priest in the opening stages of their illness than to a psychiatrist.
Their membership of a church may not be without problems: if their behaviour is also disturbed, then this may present the other members of the community with difficulties. How do they preserve the dignity of their place of worship and of their liturgy, while at the same time ministering to someone who is clearly ill and in need of their help and support? This can often be a challenge for the community. Prayer can often be the only option left to faith communities in the midst of this dilemma.
The challenge for the person with schizophrenia is just as great. Schizophrenia, unlike a physical illness, often deprives the individual of the mental capacity for meaningful prayer; in this case, he or she relies on the other members of the community to do the praying.
When recovery begins, a person must then find a way of sorting out the rational religious thinking from among all of the great emotional and psychological tangle of his or her delusions. This process can take time and considerable effort.
The clergy are often unprepared, too, and will not know how best to help the person with schizophrenia. They are not, after all, given any formal training in mental health, and can be forgiven if their initial response is not always appropriate. The support that they can provide, however, particularly to the relatives of the sufferer, can often be invaluable. Clergy can also guide the congregation to assign context to the individual’s disturbed behaviour, seeing it as a symptom of the illness rather than a malicious act.
But most people with schizophrenia do make a substantial recovery, eventually, and their faith will often be an important component of that recovery process. Research has shown that, later in the course of the illness, when people start to recover a reasonable level of functioning, religious belief and membership of a supportive faith community can be a positive asset.
People who are recovering from schizophrenia and who are members of a faith community will experience fewer symptoms, and have a lower risk of suicide. In addition, their faith will help them to deal better with the normal stressful life events that can, if not coped with well, precipitate a relapse in their schizophrenic symptoms.
Schizophrenia presents members of faith communities with real challenges: in how we practically minister to people with this cruel condition, and in how we help them and their relatives in their daily lives. But, for the people with schizophrenia, there is perhaps one easy formula to remember: trust in God, but keep taking the medication.
David Bell is director of Living with Schizophrenia: a UK-based project that provides information and advice about this condition. www.livingwithschizophreniauk.org